Resident doctor who messed up

Hi,

I’m an intern doctor who started my residency in June, and I’m in a tough spot. According to HR, I chose a health insurance plan in the first week of June but didn’t “confirm” it. Apparently, I was supposed to go back and confirm it in early July. I’ve been working over 80 hours a week and didn’t have the time or energy to deal with their weekly reminders. I thought I was set after selecting my insurance.

I just found out I’m not covered when I tried to get a routine vaccine. What can I do now? I’m working hard to resolve this with my employer, but I doubt they’ll change their stance.

I’m considering a strategy but want to stay within the rules. Open enrollment is in November. Can I sign up for marketplace insurance and then cancel it right away to enroll with my employer? HR mentioned that losing insurance for any reason is a qualifying event. If I cancel because it doesn’t meet my healthcare needs, is that acceptable? Please help!

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You probably don’t qualify for any special election periods, so you’ll need to go without coverage for the next few months. However, you might be able to purchase a non-qualifying catastrophic plan in the private market to cover yourself until the new plan year begins.

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Why not? Isn’t loss of insurance considered a qualifying life event (it doesn’t matter for what reason)?

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Yes, you are outside the timeframe for a qualifying life event (QLE) for losing your prior insurance. By not clicking “confirm,” you missed your opportunity. I understand it doesn’t seem fair.

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Not to mention, you cancelling your marketplace plan is not a QLE. It’s a voluntary loss of coverage.

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Did you start your residency as a new hire and complete the new hire enrollment? If that’s the case, when does your employer’s annual open enrollment occur? Is it in November for a plan that starts in January, or does it happen at another time?

Yes, open enrollment for ACA/marketplace plans starts on November 1 for plans that take effect on January 1, 2025.

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No, unfortunately my employers open enrollment is in February.

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Here’s an unethical life pro tip: One hospital employer accepted “began using tobacco” as a qualifying life event (QLE). Seriously. A colleague started smoking to change their benefits. Your mileage may vary. Be sure to ask your benefits department to clearly list what qualifies as a QLE.